It may not be what you think.
This is an edited, partial transcript of an interview conducted last week by Matthew Rothschild, the editor of The Progressive, with Wendell Potter, the former PR guy with the health insurance industry who has now turned whistleblower. Potter works for the Center for Media and Democracy (prwatch.org). To hear the whole interview, click here.
Q: In the President’s speech, I think he all but sawed the plank out from underneath the public option by saying we “can” have it instead of we “must” have it, and then by saying we could always have co-ops or a trigger? What did you make of these specifics on the public option?
Wendell Potter: I was disappointed. When he was talking about the public option initially, I thought he made a good case for it. But when he was talking about the other possible options, that clearly was a signal that he’s very willing to sign a bill without it. And that distressed me because during the campaign he was very much in favor of a public option, and he was alone among the leading candidates in opposing an individual mandate. And now it looks like he’s swapping there.
Q: What’s wrong with an individual mandate?
Wendell Potter: If there’s no public option, that means you will have no alternative, if you’re not eligible for a public program that already exists, you’ll have no alternative but to buy your coverage (I would say your overpriced coverage) from a private insurance company. That’s the problem I have with it, and that’s the problem the President had with it during the campaign. Why would you force people to buy something they can’t afford? The solution, of course, is to give people a subsidy to buy. But I have a problem with that, too. Our tax dollars will be subsidizing premiums that will go to these for-profit insurance companies.
Q: If there is no public option, what is to stop the insurance companies from jacking up prices?
Wendell Potter: There’s not going to be anything to stop them. . . .
Q: At least rhetorically, it sounds like the insurance companies are willing to go along with legislation that would force them to cover people with preexisting conditions and requiring them not do rescissions (where they deny people care on a technicality, even when those people have been paying their premiums). Now I’m a pretty cynical person, I guess, so why would they go along with that, or will they find a way to weasel out of it?
Wendell Potter: Your word “rhetorically” is apt there because they said the same thing in 1993 and 1994. I can point to Congressional testimony where they were saying pretty much the same things they are saying now. That is part of what I call their duplicitous campaigns. . . . I think they think the chances of reform are greater this time than ever before, and they will be willing to do these things because all of them would have to abide by new regulations. Everybody in the industry will be playing by the same rules. What they would gain, though, is millions and millions and millions of new members. So that’s why they’d be willing to do this. They’ll be getting a lot more people to cover. Many will be young people who are healthy. They will be getting premiums from those people, and many of those will be coming from the government. Because most people who are uninsured can’t afford the premiums so there will have to be government subsidies. . . . They will agree to this, but it will not mean that the pressure from Wall Street will go away. In fact, with more people in the system, they will be looking for new and creative ways to avoid paying claims and to making sure they’re meeting Wall Street’s expectations.
Q: If there’s no public option, and I don’t think there’s going to be a public option, the Blue Dog Democrats are talking about co-ops as though that’s going to be a solution. You’ve called co-ops “a sheer fantasy.” Why is that?
Wendell Potter: I think the idea may have actually come from the insurance industry. There is just no chance they can be created with enough substance and size to be able to compete with these big companies. The industry has consolidated significantly over the past several years. As the President noted in his speech, some markets are dominated by very, very large companies, sometimes 75 percent to 90 percent in a state. A co-op is not going to be able to take business away from dominant players like that, which have very good (for the insurance company) contracts with providers. They get those contracts because they can demonstrate that they can get a lot of people, and they can deliver patients to doctors and hospitals. A start-up co-op just won’t ever be able to scale up large enough to really compete in markets. It’s just not going to happen.
Q: We’re going to be junking a public option for something that will be incredibly insignificant?
Potter: Oh, absolutely. Very incredibly insignificant.